Health Systems Strengthening

Health Systems Strengthening is critical to improving health care and services for people in all nations, and is especially important in low- and middle-income countries and areas experiencing or recovering from conflict and major natural disasters.

Country Spotlight Series

CCIH produced a series of pieces exploring health in a number of countries and the faith-based health care landscape. In each country, we spotlight a few faith-based organizations and how they impact health care services in the country.

Bangladesh: Bangladesh has struggled to meet the need for qualified health workers in rural areas, as many health care providers remain concentrated in urban areas. Non-governmental organizations (NGOs) play an important role in reaching people in other areas with health services. Faith-based organizations LAMB and World Renew make substantial contributions to the health system in Bangladesh through their work in maternal and child health, family planning, nutrition, immunization, water and sanitation, and overall health systems strengthening.

Ghana: The Christian Health Association of Ghana (CHAG) and American Leprosy Missions are faith-based organizations working in maternal and child health, family planning, nutrition, immunization, water and sanitation, and overall health systems strengthening in Ghana. CHAG is a network of 326 health facilities and 20 health training and teaching institutions owned by 34 different Christian Church denominations. CHAG delivers 30% to 40% of health services within Ghana and is recognized by the Ghanaian government as an implementing partner of the Ministry of Health. ALM is a global organization serving Christ by curing and caring for people suffering from leprosy and related diseases. This spotlight provides an overview of their work and includes some health indicators for Ghana.

India: With India’s public health expenditure around 1.15% of its Gross Domestic Product, there is an insufficient supply of publicly funded healthcare facilities and health professionals. Alongside the public sector, the private sector is responsible for over 70% of outpatient care and 60% of inpatient care. It is also estimated that 21% of individuals in India fall below the poverty line. Faith-based organizations are integral to meeting the needs of individuals who cannot access public healthcare due to poverty and lack of access in rural settings. The piece features the work of the Christian Medical Association of India, Emmanuel Hospital Association, Comprehensive Rural Health Project, and the Catholic Health Association of India.

Malawi: Faith-based organizations provide a significant amount of healthcare in many nations, including Malawi. The Christian Health Association of Malawi, the Evangelical Association of Malawi, LifeNet International, and World Renew are FBOs who contribute to the country’s health services in the areas of family planning, immunization, nutrition and WASH, as well as overall health systems strengthening.

Nigeria: Faith-based organizations play a significant role in providing healthcare in Nigeria. This spotlight features the work of a few FBOs, including the Christian Health Association of Nigeria, Rural Health Services, Isaiah 58 Care Foundation, Life Builders Ministries International, and World Renew. These organizations are working in family planning, immunization, nutrition, WASH, overall health systems strengthening and more.

Tanzania: FBOs are the largest providers of hospital services in Tanzania, owning 41.1% of hospitals, and the second largest provider of health services, owning 23.3% of total health infrastructure. This piece features the work of Mennonite Central Committee, Friends of Shirati and the Christian Social Services Commission and their contributions to the Tanzanian health system.

Uganda: The contributions of faith-based organizations in health care delivery in Uganda are significant. Here we feature three Christian organizations that deliver or support health services in Uganda, including the Uganda Protestant Medical Bureau, the largest network of faith-based health organizations in the country; LifeNet International which operates in Uganda; and HERE AM I Ministries.

Zambia: FBOs play a significant role in providing healthcare in Zambia. This spotlight features the Churches Health Association of Zambia, Catholic Medical Mission Board (CMMB Zambia), and World Renew Zambia, and their work in family planning, immunization, nutrition, WASH, and overall health systems strengthening.

Country Health System Reports

In addition to our blog-style Country Spotlight Series featured above, CCIH commissioned detailed reports on the health system, including the history of faith-based care, in two countries.

The report on the contribution of faith-based organizations on the health system in Nigeria was released in March 2021. See Nigeria Report

The report on the contribution of faith-based organizations on the health system in Liberia was released in April 2021. See Liberia Report

Health Facility Mapping Resources

How To-Video

CCIH prepared this How-To video using data from the Christian Health Association of Sierra Leone (CHASL) to help organizations interested in mapping their facilities. We are also working on other types of mapping support. This video guides users through the simple features of Google Maps in order to create specific points, routes, and networks.

CCIH Health System Strengthening Focus Groups

CCIH hosted faith-based organizations based in Malawi and Kenya to discuss health systems strengthening from a faith perspective in April and May 2019. The goals of the meetings were to share and learn through an honest and open dialogue with other faith-based health organizations running health facilities and/or community programs regarding health systems successes and needs; develop concrete organizational profiles with HSS successes and needs that will be used to share with potential donors and partners (longer term); and seek or identify any geo-mapping or electronic lists/databases of health facilities, programs or related services, or initiatives to create those (longer term).

See the report from the workshop in Kenya and the report from the workshop in Malawi.

General HSS Resources

Webinar: Building Resilient Heath Systems through Faith-based Organizations | CCIH partnered with IMA World Health to host a webinar on October 21, 2016 on Health Systems Strengthening featuring experts from Christian health networks in Africa. The speakers addressed how the faith-based organizations they work with partner with other FBOs and their governments to strengthen health systems, along with other issues, such as workforce retention. Speaking on the webinar were Tonny Tumwesigye, MD, MPH, Executive Director, Uganda Protestant Medical Bureau, Theresa Nyamupachitu, Senior Program Advisor for Health Systems Strengthening, IMA World Health and Peter Yeboah, Executive Director of the Christian Health Association of Ghana.

Health Systems Strengthening in MCSP Country Programs: A Review of MCSP’s Work to Strengthen | The Maternal Child Survival Program (MCSP) incorporates health systems strengthening (HSS) approaches to support programming along nine technical areas—family planning, maternal health, newborn health, child health, immunization, nutrition, malaria, HIV/AIDS, and water, sanitation, and hygiene (WASH). To understand the breadth of MCSP’s HSS work within country programs, the Health Systems Strengthening and Equity team conducted a comprehensive review of country program workplans active during the fourth program year (October 2017–September 2018), mapping activities to the HSS strategies identified in the 2017 USAID’s Acting on the Call report.

WHO Health System Pillars

The following resources are structured around the six pillars of a health system as described by the World Health Organization.

1. Leadership and Governance

Leadership Tools from the Arukah Network | CCIH member, the Arukah Network offers tools to help strengthen Leadership, Communications, Healthcare and more.  See the tools

Nonprofit Management Training from NonprofitReady. Its mission is to enable nonprofit professionals and volunteers to develop their career and do more good by providing high quality, relevant online learning resources at no cost.

2. Healthcare Financing

Webinar: Global Health Financing: Changing Landscape and New Opportunities for Local Organizations | CCIH hosted this webinar on October 24, 2018. The funding and partnership landscape is changing, creating new opportunities – and challenges – for faith-based organizations. Both USAID and PEPFAR are placing increasing focus on in-country organizations and supporting efforts to build the capacity of local groups, resulting in stronger, more resilient and self-sufficient communities. New approaches to public-private partnerships, especially including corporate partners, are increasingly important in the global health financing landscape. This CCIH webinar featured Dianna Lightfoot, Advisor, USAID Bureau for Global Health and Priya Sharma, Senior Policy and Innovative Financing Advisor, USAID Bureau for Global Health. Jenelle Williams, Program Director, Global Health Action moderated the session.

Interview from the 2021 CCIH Conference with Dr. Lydia Dsane-Selby, Chief Executive Officer of Ghana’s National Health Insurance Scheme Health Insurance and Mobile Money on Ghana’s Experience with mobile money payment.

3. Healthcare Workforce

Faith-based Organizations: Using HR Management to Support Health Workers | Sarah Dwyer | CapacityPlus/IntraHealth International | This publication is from the CapacityPlus Voices series and explores how faith-based organizations are working to strengthen human resources for health and features the work of Christian Health Associations in Africa.

How Can Governments Work with Faith-based Organizations to Strengthen the Health Workforce? (Issue Brief) | CapacityPlus | This brief presents an overview of FBOs and human resources for health along with suggested actions, key considerations, and resources. Also Available in French

Partnering with African Faith-Based Organizations for a Strong Health Workforce | CapacityPlus | Doris Mwarey, Craig Hafner, Theresa Nyamupachitu | This technical brief highlights efforts that African faith-based organizations are making to strengthen their health workforce and integrate national health systems, with the goal of improving health outcomes.

4. Medical Products and Technology

Donated Medical Equipment | See this resource for a listing of organizations that work in the area of donated medical equipment. They may service and repair donated equipment before it is sent to a hospital, clinic or other organization in need; offer match-making between entities who have a donation and those that have a need; and/or offer guidelines to help organizations maintain quality in donated equipment. It is very important to pay attention to guidelines on donated medical equipment, such as those from PQMD included with the listing.

Accord Network Inter-Agency Gift-in-Kind StandardsAccord Standards serve to raise the bar of ethics in the industry so that by transparency and integrity, so adherents are able to increase the level of donor and end user trust in the way donations of pharmaceutical and medical equipment are received, distributed and recorded.

Journal Article: Access to medical devices in low-income countries: Addressing sustainability challenges in medical device donations. Discussion Paper, National Academy of Medicine.  Compton, B., D. M. Barash, J. Farrington, C. Hall, D. Herzog, V. Meka, E. Rafferty, K. Taylor, and A. Varghese. 2018.

5. Information and Research

Visit the Christian Journal for Global Health, a peer-reviewed, scholarly and multidisciplinary journal on global health policy and practice, promoting evidence-based and thoughtful analysis on effective and innovative approaches to global health from an integrated Christian perspective.

6. Service Delivery

The WHO Surgical Safety Checklist has improved compliance with standards and decreased complications from surgery in eight pilot hospitals where it was evaluated. Complete the form to register your hospital or health care facility and implement the Safe Surgery Saves Lives Checklist.